1998 asa media kit

AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 DENISE M. JONES, DIRECTOR OF COMMUNICATIONS NEWS RELEASES FOR 1998 ASA ANNUAL MEETING First-of-its-kind research discovers a link between certain foods and patients’ reactions to anesthe-
A surgically implanted device can provide relief and mobility to cancer patients suffering with
extreme pain.
A treatment for lower back pain bridges acupuncture with Western medicine.
Studies show that age and/or gender may predict how patients recover from heart bypass surgery
and how much blood they will need for transfusions.
A growing class of drugs being prescribed or made available over-the-counter could cause some
patients to have adverse reactions while under anesthesia.
These are just a few of the interesting scientific presentations outlined in the 1998 American Society ofAnesthesiologists (ASA) annual meeting media kit. The meeting will be held in Orlando on October 17-21. During the annual meeting, you can reach communi-
cations staff members between 8 a.m. and 5 p.m. in the ASA press room at the Orlando/Orange County
Convention Center, Room 231 A-B, telephone: (407) 248-5010. ASA staff members will be on hand to assist
you in scheduling interviews, locating individuals and providing general background information.
Most of the news releases are embargoed until their presentation date. However, if you cannot attend themeeting, members of the ASA communications department can assist you in arranging interviews with thepresenters prior to the meeting.
For assistance in arranging interviews or for further information prior to the annual meeting, please contactthe ASA Executive Office, 520 N. Northwest Highway, Park Ridge, IL 60068-2573, or call (847) 825-5586. Weare also available by e-mail: ASA will not be sending out the ASA annual meeting program book unless specifically requested in advance.
Copies of the program as well as the scientific abstracts and refresher course outlines will be available in thepress room.
For more information about the 1998 Annual Meeting, ASA and the medical specialty of anesthesiology, visitour World Wide Web site: This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 LIST OF PRESS RELEASES
ASA ANNUAL MEETING
October 17-21, 1998
DEER, TIMOTHY R.
STAATS, PETER S.
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Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 HEADING HOME MINUTES AFTER SURGERY
ORLANDO — New anesthetic agents and improved surgical techniques enable many patients to wake up and recover from anesthesia in a fraction of the time of traditional medications. This means more patients are able to safely bypass the recovery room, Jeffrey L. Apfelbaum, M.D., vice chair of anesthesiology and critical care medicine at the University of Chicago, said at the American Society of Anesthesiologists annual meeting.
A University of Chicago study involving five community hospitals found that 15 percent to 40 percent of patients who underwent outpatient surgery with new, short-acting anesthetics were able to safely sidestep the recovery room altogether, Dr. Apfelbaum said. These recent medical strides have made it safe for some types of surgery, even complex procedures, to take place in doctors’ offices, Dr. Apfelbaum said. He estimated that 7 percent to 10 percent of surgery is already being performed in office settings, and he said the trend is growing. The trend toward office-based surgery is also being fueled by anesthesiologists’ ability to deliver com- prehensive, state-of-the-art anesthesia care in office settings without compromising patient safety and comfort “As with outpatient surgery, office-based surgery began with minor procedures such as the removal of moles but is quickly progressing to major procedures, including gall bladder removals, breast augmentation surgery and pacemaker placements,” Dr. Apfelbaum said.
It’s hard to say where the trend will stop, he said. “It took a long time for patients and third-party pay- ers to accept ambulatory surgery, and yet today, 70 percent of surgery is performed on an outpatient basis.” The trend is being fueled in part by the development of short-acting general anesthetics that has allowed patients to regain consciousness and alertness quicker than ever before, he said. Many procedures today are performed with regional anesthesia instead of general anesthesia. The technique is used to numb only a specific region of the body. Used alone or in combination with general anesthesia, it provides superior pain relief up to 36 hours after surgery. Combined with newer nonsteroidal, anti-inflammatory analgesics to This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
relieve pain after surgery, the technique improves patient comfort by replacing or reducing the need for nar- cotics, which can impede recovery because they can cause drowsiness, nausea and other adverse side effects. Patients feel more comfortable when they know what to expect, Dr. Apfelbaum said. For most sched- uled surgeries, patients will have an opportunity to ask their surgeon and their anesthesiologist a few simple • Ask if your surgery will be done in the hospital, outpatient surgical center or in the doctor’s office.
• Ask what method of anesthesia will be used (local, general or regional block).
• Ask if there will be an anesthesiologist available who will continually monitor your vital signs Dr. Apfelbaum believes the growth of office-based surgery will be driven by safety and patient demand. “Whether it’s breast augmentation or a gall bladder operation, patients want to get over whatever it is they’re having done as quickly as they can, with little interruption in their normal lives,” he said. This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 JAMES F. ARENS, M.D., TO RECEIVE ASA’S HIGHEST HONOR
ORLANDO — James F. Arens, M.D., Galveston, Texas, was named the recipient of the 1997 American Society of Anesthesiologists (ASA) Distinguished Service Award during the society’s annual meeting in October. Dr. Arens is past president of ASA (1989) and is the immediate past president of the American Board of Medical Specialties (ABMS), the only anesthesiologist to serve in that capacity.
The ASA Distinguished Service Award is the society’s highest honor bestowed to an individual for lifetime achievements and service in the specialty and the society. Nominations for this annual award may be submitted by any ASA member or component society and are then reviewed by the Committee on Distinguished Service Award. The candidate entered into nomination by the committee must receive a two- thirds vote of more than 300 delegates seated in the ASA House of Delegates who represent more than 34,000 Dr. Arens’ many professional involvements with ASA include serving as current chair of the Committee on Practice Parameters (since its inception in 1992) and as ASA delegate to the American Medical Association. He was appointed in 1998 to a three-year term to represent ASA on the Residency Review Committee for Anesthesiology. He also served as ASA Vice-President for Scientific Affairs (1984-86), First Vice-President (1987) and President-Elect (1988).
Dr. Arens is Vice President for Clinical Affairs, Chief Executive Officer and Professor of Anesthesiology at the University of Texas Medical Branch Hospitals, Galveston, Texas.
Dr. Arens also has served as ABMS President-Elect (1995) and Vice President (1994) and served as a director of the American Board of Anesthesiology (1975-87), including as president in 1986. He also served as the ABMS representative to the Accreditation Council for Graduate Medical Education for six years from According to Dr. Arens, however, of all his accomplishments, he is proudest of the more than 200 anesthesiology residents he has trained during his career.
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AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 FROM SNAILS TO FIBEROPTICS, NEW TREATMENTS OFFER HOPE TO PATIENTS IN
EXTREME PAIN
ORLANDO — A drug derived from the poison of a Philippine sea snail and new fiberoptic technology for viewing the spine are giving anesthesiologists powerful new tools with which to relieve the suffering of patients living with persistent, excruciating pain.
These are two of several promising developments in the management of severe pain reported this year at the American Society of Anesthesiologists annual meeting. Severe pain often associated with many diseases or injuries such as cancer, multiple sclerosis or back injury had been untreatable or only partly manageable.
“Eighty-six million Americans suffer from chronic pain,” anesthesiologist Peter S. Staats, M.D., direc- tor of the division of pain medicine at Johns Hopkins University, said. “Though we can control most of this pain with nerve blocks and oral medications, some conditions require more radical approaches.
Advancements in the use of these techniques are allowing us to bring long-lasting relief to people for whom • Spinal endoscopy: The technology gives anesthesiologists their first direct view of the nerves, scar
tissue and coverings of the spine and received Food and Drug Administration (FDA) approval this year.
Timothy R. Deer, M.D., an anesthesiologist at West Virginia University and CEO of the Center for Pain Relief in Charleston, West Virginia, reported that this new procedure allows physicians to look inside the body and to diagnose and treat everything from disc herniation to spinal scarring without extensive surgery. “It took longer to develop spinal endoscopy because the instrumentation had to be much smaller than current endo- This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
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A fiberoptic camera inserted through a small incision near the spine sends an image to a video monitor.
“With a direct view of tissue in the epidural space surrounding the spine, we can locate the source of pain for many types of problems and test whether a given treatment, such as the injection of medication along a partic- ular nerve route, will be worthwhile,” Dr. Deer said. The small fiberoptic technology also allows anesthesiologists to insert special instruments through the scope to remove an accumulation of scar tissue that can occur after spine surgery or injury and cause extreme • Intrathecal infusion systems: Small devices, surgically implanted by anesthesiologists, deliver
medication via a small tube placed directly into the fluid surrounding the spine (the intrathecal space) have been used since the 1980s to relieve severe pain. Now, programmable systems let anesthesiologists vary the rate of infusion of pain medication to the intrathecal space during the course of the day to match a patient’s pain level. The programmable systems fine-tune pain control for patients whose discomfort worsens at certain times of day, Dr. Deer said. New drugs for use with intrathecal infusion devices are also enabling anesthesiologists to help patients, the researchers said. One promising drug is derived from the venom of the conus magus, a sea snail found off the coast of the Philippines that paralyzes its prey by “shooting” an “arrow” of poison at it. Researchers have isolated a compound in this poison that binds to the spinal cord in the location where pain is processed, block- ing the transmission of pain. Recent clinical trials have demonstrated the medication’s effectiveness as a potent pain reliever and as an attractive option for patients who do not tolerate morphine well, Dr. Staats said. Also promising is baclofen, a new member of the group of drugs known as GABA-b agonists. These drugs work by artificially restoring the central nervous system’s ability to inhibit the transmission of pain impulses. Multiple sclerosis, cerebral palsy and spinal cord injuries destroy this inhibitory capacity, producing uncontrollable, often painful muscle spasms.
“Many patients continue to experience terrible spasms even when they are taking the maximum oral dose of baclofen,” Dr. Deer said. “The intrathecal infusion of baclofen, however, offers new hope.” • Spinal cord stimulation: Used primarily in patients with extreme back pain for whom even surgery
has failed, spinal cord stimulation involves the surgical implantation of a small electrode in the epidural space surrounding the spine. The electrode is powered by a battery implanted under the skin in the hip area and operated by an external radio frequency device. It is believed that spinal cord stimulation works by opening up pathways in the central nervous system Although spinal cord stimulation has been used for 30 years, ongoing improvements have greatly increased its effectiveness, Dr. Deer said. New “dual lead” systems made possible by advances in computer technology now allow anesthesiolo- gists to stimulate more than one area of the spine simultaneously, he said. “Two leads (wires attached to the electrodes) can be programmed to stimulate the back and either the legs or arms at the same time,” he said.
“Before, you had to choose either the back, one arm or one leg.” These systems look promising for the treatment of scarring in the spine that has resulted in pain in This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
both legs, radiation neurotitis (a nerve injury caused by cancer radiation), diabetic neuropathy (a severely painful abnormal functioning of the nerves in the extremities) and other conditions affecting more than one This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 THE TIME FOR FUTURE DOCTORS TO ENTER ANESTHESIOLOGY IS NOW
ORLANDO — Contrary to media reports and the perceptions of some medical students and even a few med- ical school advisors, practice opportunities for anesthesiologists are excellent, Norig Ellison, M.D., past presi- dent of the American Society of Anesthesiologists, said at the society’s annual meeting.
Following a long-standing shortage of anesthesiologists in this country earlier this century, the growth of the medical specialty of anesthesiology peaked in 1991 when a record 950 American medical school gradu- ates chose anesthesiology as their specialty, Dr. Ellison said. No one knew what to expect in 1995 when this largest crop of medical school graduates ever to enter anesthesiology finished their residency training and “Only some of these doctors had difficulty finding the types of ‘golden’ positions that had for decades been waiting for anesthesiologists upon graduation,” Dr. Ellison said. “Yet this temporary oversupply of anes- thesiologists led immediately to the perception by medical students that anesthesiology was no longer the out- standing opportunity it once was, causing a precipitous drop in the number of medical school graduates choos- ing to specialize in anesthesiology, “ Dr. Ellison said. By 1995, the number of medical school graduates entering anesthesiology residencies was 410; by 1996, it was 170.
“The perception that now there is an excess of anesthesiologists and too few jobs does not fit the reali- ty,” Dr. Ellison said. Last year, he noted, the number of medical school graduates entering anesthesia was up to 480. “We will need between 400 and 800 anesthesiologists per year just to fill vacant positions created by attrition, death and retirement,” he said.
Furthermore, the “graying of America” will likely increase the number of surgical procedures per- formed each year, requiring more, not less, involvement by anesthesiologists. Although the development of new surgical techniques has simplified many procedures, there will be a parallel growth in complex surgeries, including radical cancer procedures, aggressive trauma surgeries and an enormous growth in organ transplan- “I don’t think the simpler procedures will decrease the demand for anesthesiologists,” Dr. Ellison said.
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“There will be an increase in more complex procedures that will take longer and consume more hours of anes- At the same time, surveys indicate that the public prefers to have physicians in charge of their anesthe- sia care, and anesthesiologists are redefining their specialty, he said. “We now look at ourselves as periopera- tive specialists, helping prepare patients for surgery, managing postoperative care, and managing critical care Dr. Ellison said the increased numbers of physicians entering the medical specialty of anesthesiology allows for increased research activity into such areas as advances in anesthetic agents, patient monitoring technology and patient safety, all of which ultimately benefit patients who receive anesthesia.
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Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 ANESTHESIOLOGISTS REDEFINE THEIR SPECIALTY AS HEALTH CARE UNDERGOES RADI-
CAL CHANGES
ORLANDO — The medical specialist known to most people as the doctor who puts patients to sleep for surgery is just as likely today to be found caring for patients before they enter the operating room (O.R.) and after they leave it, Thomas W. Feeley, M.D., said at the American Society of Anesthesiologists annual meet- As the American health care system shifts to a predominant managed care environment, anesthesiolo- gists are adapting by bringing their medical expertise to a growing number of settings outside the O.R., he Broadening their responsibilities and redefining their specialty, they are quickly becoming medicine’s perioperative physicians, overseeing the evaluation of patients before, during and after surgery and diagnostic procedures as well as managing the recovery area and postsurgical intensive care or critical care unit.
Anesthesiologists are also involved in pain management, pain relief for laboring women, emergency resuscita- tion and end-of-life care for hospitalized and hospice patients, he said.
“Anesthesiology departments are being asked to take on ever-increasing responsibilities for both inpa- tients and outpatients in addition to providing anesthesia for surgical and diagnostic procedures,” according to Dr. Feeley, who is the Charles M. McBride Professor of Surgical Oncology and head of anesthesiology and critical care at the University of Texas M.D. Anderson At the M.D. Anderson Cancer Center, for example, the anesthesiology department oversees supportive care for cancer patients, including the management of pain, fatigue, nausea and vomiting, and also supervises physical medicine and rehabilitation and medical and surgical critical care. “With the help of other specialists, departments of anesthesiology can provide a wider range of ser- vices to patients safely and economically,” he said. Though much of the transformation is being driven by This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
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economic forces, anesthesiologists, by virtue of their medical training, are well-prepared to assume many new “The management of medical critical care and surgical intensive care units, for example, is a natural progression for anesthesiologists because the life support systems used in intensive care are virtually identical to the life support systems managed by anesthesiologists in the O.R.,” Dr. Feeley said. Most critical care in countries other than the United States is already handled by anesthesiologists, he said, and in the United States, anesthesiologists are applying for fellowship training in this field in unprece- dented numbers. “Anesthesiology departments are being looked at as the place from which services such as Anesthesiologists receive more extensive training and experience in the pharmacologic and nonphar- macologic management of pain than any other medical specialty, Dr. Feeley noted. As a result, they are also being asked to develop and run outpatient pain services to relieve the suffering of patients with everything from lower back problems to cancer to neuropathic pain, a complication of many diseases.
“Anesthesiologists are trained to relieve pain safely and are currently the only medical specialists with a board-certified subspecialty in pain management,” Dr. Feeley said. Anesthesiologists’ pain management expertise also uniquely qualifies them to administer labor analge- sia to obstetric patients, to provide end-of-life care for hospitalized and hospice patients, and to handle the sur- gical implantation of such leading-edge devices as drug infusion systems and electrical spinal cord stimulators for the treatment of pain that does not respond to traditional methods, Dr. Feeley said.
Anesthesiologists are putting their expertise to work in the preoperative arena as well, helping to streamline procedures and lower costs. “When the preoperative process is driven by an anesthesiologist, stud- ies show the cost of laboratory tests are reduced by 59 percent, or $112 per patient,” he said. “An anesthesiol- ogist knows what tests the anesthesiologist in the O.R. needs, and does not need, to plan anesthesia for a given This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
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AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 STUDY FINDS STRIKING GENDER DIFFERENCES IN COSTS OF
HEART SURGERY
ORLANDO — The cost of coronary artery bypass graft surgery (CABG) is 20 percent higher for women than men, according to studies performed by Yale University researchers and reported at the American Society of A study of 550 patients undergoing CABG surgery in 1997 found that women spend significantly more time on mechanical ventilation and in the hospital after surgery, even though men experience more complica- The amount of time of mechanical ventilation for women in the study was 19.8 hours versus 12.9 hours for the men while the time spent in the hospital following surgery was 7.3 days for the women but only The study found no significant differences between men and women in the severity of heart disease before surgery, and the large cost gaps between men and women persisted even after adjusting for any differ- ences in age and risk factors, such as the presence of other serious illnesses, anesthesiologist Manuel L.
“What we need to know is why there is such a significant difference in cost between men and Unknown physiological differences between men and women may explain the gender-related cost dif- ferences. “Perhaps female patients spend more time on mechanical ventilation because they metabolize anes- thetic drugs slower than men do,” he said. “If that is true, we need to question the current dosing of drugs based only on body weight, and we may need to select potent drugs that are quickly metabolized regardless of This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
Part of the answer may lie in differences in support systems between men and women, Dr. Fontes said.
“Women tend to outlive men, so there are many more single older women than single older men,” he said.
“Perhaps men are discharged earlier because they are more likely to have someone at home who can take care Further research is under way at Yale to study these support systems, Dr. Fontes said.
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Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 ‘SMART’ INTENSIVE CARE UNIT BOOSTS EFFICIENCY, LOWERS COSTS
ORLANDO — Anesthesiologists at the University of Pennsylvania, Philadelphia have developed the proto- type for a “smart” intensive care unit (ICU) that automates key aspects of patient care. The smart system could function in the ICU as a “skilled assistant,” enhancing the anesthesiologist’s or ICU nurse’s efficiency by monitoring a patient’s vital signs, spotting and remedying potentially dangerous deviations from the patient’s “ideal” heart rate, blood pressure and blood flow quickly, C. William Hanson III, M.D., said at the annual meeting of the American Society of Anesthesiologists. By taking on much of this demanding job, the system would significantly decrease hospital costs by freeing clinicians to safely care for more patients at one time in the ICU, Dr. Hanson said. The system would enable an ICU nurse to care for three or four patients rather than one or two, he said. The system uses two types of artificial intelligence: a neural network and a fuzzy logic controller.
The neural network learns in the same manner as the human brain. As the network interacts with data, it is reinforced for good performance and “punished” for poor performance. The smart ICU’s neural network can quickly learn the ideal health status for a given patient. The fuzzy logic controller is a smart pump that administers intravenous fluids (e.g., saline, medication or blood) at the rate and volume needed to maintain the ideal as determined by the neural network. Fuzzy logic more closely resembles human thought and behavior than traditional computer logic because of its abili- ty to manipulate “fuzzier” concepts such as “almost,” “near,” “cooler” and “very far.” Fuzzy controllers have been used with great success to enhance the performance of everything from air conditioners and ship-loading cranes to subway systems and elevators, Dr. Hanson said.
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Designed to support clinicians, not replace them, these tools can perform specialized, complicated “Artificial intelligence tools such as these are ideally suited for patient care applications,” he said.
“This system can do one thing with uncanny skill: assist the anesthesiologist in recognizing important trends This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 KEEPING CHILDREN CALM BEFORE SURGERY: WHAT WORKS BEST
ORLANDO — Giving children a sedative before surgery may do more to quell their fears than having mom or dad at their side as the anesthesiologist puts them to sleep, according to the results of a study presented at the annual meeting of the American Society of Anesthesiologists. The study of 85 patients, ages 1 to 6, found that children who were given a sedative in the preoperative holding area showed significantly less anxiety when leaving their parents, entering the operating room (O.R.) and undergoing anesthesia than youngsters whose parents stayed with them or youngsters who received no intervention at all. The parents whose children were sedated also exhibited significantly less anxiety than the other two groups when their children were taken from them to the O.R.
The study raises questions about the advisability of allowing all parents to accompany their children into the O.R., according to Zeev N. Kain, M.D., head of pediatric anesthesia at Yale University. As a group, the children whose parents were with them were no more relaxed than the children who did not receive a sedative and whose parents were not with them, he said.
“We are not suggesting parental presence has no place in the O.R.,” Dr. Kain said. “Whether or not to bring parents in is not the issue. The issue is what parents do once they are there. Even more important is what anesthesiologists do to encourage the kinds of behavior in parents that will help their children in the According to research, parents should stay calm, maintain eye contact with their child, rehearse the experience at home and avoid criticism, including statements that trivialize the experience (“Don’t be such a baby,” or “It’s not a big deal, just do it.”) “If you are anxious, realize it’s not always best to be there with your child,” Dr. Kain advised. “You may feel better because you think you’re in control, but you’ll communicate your anxiety and your child will This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
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Not surprisingly, sedation improved children’s compliance during the induction of anesthesia, the cur- rent study found. While all of the sedated children complied fully when the anesthesiologist placed the anes- thetic mask on their faces, 22 percent of children whose parents were present and 36 percent of children who received no intervention resisted in some way.
“We believe in doing whatever works, whether it’s bringing the parent into the room or giving the child a sedative,” he said, adding that individual hospitals usually sets their own guidelines for allowing par- “What we don’t want is to ignore the child’s fears,” Dr. Kain said. Another Yale study reported at last year’s ASA meeting found that a negative preoperative experience can have negative effects on a child’s This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 RESEARCH UNCOVERS FIRST KNOWN LINK BETWEEN DIET AND ANESTHESIA
ORLANDO — What types of foods you eat, even days before surgery, may determine how your body will react to anesthesia, according to a group of University of Chicago anesthesiologists.
Their findings bring anesthesiologists one step closer to understanding why patients vary so widely in their sensitivity to anesthetic drugs, principal investigator Jonathan Moss, M.D., Ph.D., said at the American Society of Anesthesiologists annual meeting.
“Body weight and height are only part of the picture in predicting how quickly a patient will metabo- lize an anesthetic agent and in deciding how much of it to administer,” Dr. Moss said. “Our results indicate some of the variability may be due to diet.” The laboratory study, one of the first to look at a connection between food and the metabolism of anes- thetic drugs, suggests that even small amounts of compounds found naturally in potatoes, tomatoes and egg- plants can markedly slow the metabolism of many local anesthetics and muscle relaxants, drugs commonly These foods contain compounds called solanaceous glycoalkaloids (SGAs), which act as natural insec- ticides. “The U.S. Department of Agriculture monitors SGA levels in potato crops because SGAs in green potatoes have been known to cause serious illness and death,” Dr. Moss said.
SGAs inhibit two important enzymes found in the human body. The first (butyrl-cholinesterase) is found in blood and is responsible for the breakdown of many anesthetic agents. The other (acetyl- cholinesterase) breaks down a chemical (acetylcholine) vital for healthy nerve and muscle function. When these enzymes are blocked, the body cannot metabolize some anesthetics and muscle relaxants, he said.
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“Our study suggests that doses of SGA, which can occur even with moderate ingestion of potatoes days before surgery, can significantly block the cholinesterase enzymes. The study may also help to explain why the dosing models of many anesthetic agents are often off by as much as 50 percent to 100 percent and emphasizes the need for skilled anesthesia monitoring of each patient,” Dr. Moss said.
“It’s very hard to predict how a patient will respond with our current knowledge of drug distribution and elimination. Perhaps what a person has eaten, even days before surgery, contributes to that unpredictabili- This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
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AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 JOHN B. NEELD, JR., M.D., INSTALLED AS PRESIDENT OF
NATIONAL MEDICAL SOCIETY
ORLANDO — Atlanta anesthesiologist John B. Neeld Jr., M.D., chair of the department of anesthesiology at Northside Hospital and Northside Anesthesiology Consultants, Atlanta, was installed as president of the American Society of Anesthesiologists (ASA) during the annual meeting in Orlando, Florida.
Dr. Neeld received his medical degree from Vanderbilt University School of Medicine, Nashville, Tenn. He received his residency training in anesthesiology from Emory University Hospitals, Atlanta.
Previously, Dr. Neeld served as president-elect (1998), first vice-president (1997), ASA treasurer (1994-96) and assistant treasurer (1991-93). He also was an ASA delegate (1982-91), an alternate director (1983-91) and a member of the committees on Governmental Affairs, Anesthesia Care Team and Manpower.
A past president of the Greater Atlanta Society of Anesthesiologists, Dr. Neeld has also served on the executive committee of the Georgia Society of Anesthesiologists and as director of the Medical Association of Atlanta. He is a member and the past chair of the board of directors at Northside Hospital and is currently a member of the board of directors of the Medical Association of Georgia Mutual Insurance Co.
Dr. Neeld is a fellow of the American College of Anesthesiologists and a diplomate of the American Board of Anesthesiology. Dr. Neeld and his wife, Gail, reside in Atlanta.
Founded in 1905, the American Society of Anesthesiologists is a scientific and educational association of anesthesiologists that was organized to advance the practice of anesthesiology and to improve the quality of care of the anesthetized patient. It is the largest organization of anesthesiologists in the world with more than This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
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AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 SURGICALLY IMPLANTED DEVICE SHOWS PROMISE FOR CANCER PATIENTS WITH
SEVERE PAIN
ORLANDO — Anesthesiologists are constantly looking for new ways to help cancer patients who suffer from what is referred to as “breakthrough pain,” which occurs in sudden, unpredictable, excruciating episodes.
They may have found an answer in a medication delivery system that is both surgically implanted and patient- A multicenter study led by Wake Forest University researchers demonstrated the system’s safety and effectiveness in reducing pain and improving the quality of life for cancer patients. The results of the study were presented at the annual meeting of the American Society of Anesthesiologists.
“The system lets patients self-administer a fixed, safe dose of morphine by pressing a small control pad surgically implanted under the skin near the ribs,” Richard L. Rauck, M.D., said. The control pad is about the size of a standard business card and is three-quarters of an inch thick. This device operates a pump that delivers morphine via catheter (a thin tube) directly to the area immediately surrounding the spine, called the intrathecal space. Bathing this area with morphine effectively blocks pain signals to the brain.
The medication is stored in a small reservoir placed under the skin near the abdomen. The reservoir can be refilled each month by the patient’s anesthesiologist. To prevent overdosing, the pump is designed to refill itself 90 minutes after the patient self-administers a dose, Dr. Rauck said.
“Intrathecal infusion devices have been used for more than a decade, but there were significant draw- backs in patient control of the doses and flexibility,” Dr. Rauck said. “For example, surgically implanted devices deliver a continuous infusion of medication, depriving patients of the ability to control their own pain relief. The only available types of patient-controlled systems are external pumps, and they greatly limit patient mobility. This new system offers both control and flexibility, and could cost half that of alternative This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
The study followed 74 cancer patients for four-and-a-half months. Dr. Rauck reported that patients experienced significant improvements in their quality of life and pain relief, even as their cancer progressed.
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AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 REGIONAL ANESTHESIA REDUCES POSTSURGICAL COMPLICATIONS AND IMPROVES
RECOVERY IN OLDER ADULTS
ORLANDO — New research confirms regional anesthesia’s superior role in reducing postsurgical complica- tions in older adults, Raymond C. Roy, M.D., Ph.D., said at the annual meeting of the American Society of Dr. Roy, chair and professor of anesthesiology at Wake Forest University, Winston-Salem, North Carolina, reviewed the results of recent studies demonstrating regional anesthesia’s ability to significantly reduce postsurgical pain, bowel dysfunction and length of hospital stay for elderly patients.
By reducing the incidence of postoperative complications related to bowel function, as well as the drowsiness, nausea and other negative side effects associated with narcotic pain wmedication, the technique shortens hospital stays by up to two days, he said. Research shows that regional anesthesia works well for about 95 percent of patients, Dr. Roy said.
Regional anesthesia delivers an anesthetic agent into the space immediately surrounding the membrane enclosing the spinal cord (epidural analgesia) or the fluid surrounding the spinal cord (spinal block). Epidural analgesia numbs specific areas of the body such as the abdomen or chest, while a spinal block numbs larger regions such as the entire lower half of the body.
Both techniques work by fooling the brain into thinking nothing is happening to the body, Dr. Roy said. “By blocking the transmission of pain messages to the brain, regional anesthesia keeps the brain from activating a response to the stress of surgery. Patients experience less pain, need less narcotic pain relief and Despite its many advantages, research indicates that regional anesthesia is not more advantageous than general anesthesia in reducing the risk of heart attacks among elderly patients during and after surgery, Dr.
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Regional anesthesia is also no more effective than general anesthesia in preventing postoperative con- fusion in elderly patients, Dr. Roy said. Though the finding surprises researchers, he said, it may be partly explained by the fact that patients who receive regional anesthesia also receive sedatives, which may con- This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 WIDESPREAD PSYCHIATRIC DRUG USE POINTS TO NEED TO EXPLORE INTERACTIONS
WITH ANESTHESIA
ORLANDO — Anesthesiologists routinely ask patients to tell them what medications they are taking before surgery. This information helps them plan safe, effective anesthesia tailored to patients’ individual needs. Yet some patients are not reporting their use of psychiatric drugs, which are among a growing class of drugs being prescribed or made available over the counter. Studies into the interaction of these drugs with anesthesia are critical, researchers at the American Society of Anesthesiologists annual meeting said.
In the first study of its kind, researchers at Tulane University School of Medicine in New Orleans found that nearly half of patients over the age of 21 scheduled for elective surgery were taking one or more of these medications. They include the full range of prescription and nonprescription psychotropic, or antide- pressant, drugs — everything from Valium to Prozac to the herbal product, St. John’s Wort.
“The finding has significance because both psychiatric drugs and anesthetic drugs temporarily alter brain chemistry and cell membranes in the central nervous system, but little is known about how these two groups of drugs interact,” anesthesiologist Corey S. Scher, M.D., said. “The rapid influx of new psychiatric drugs on the market over the past 10 years underscores the need to understand the relationships between these two groups of medications,” he said. “If both types of drugs work in similar ways — and we believe they do — the impact on anesthesia needs to be defined.” In the meantime, patients should be sure to tell their anesthesiologist during the preoperative assess- ment if they are taking any of these drugs. “Not doing so is like a diabetic not revealing that he or she is on There is also considerable overlap between the two groups of drugs. Anxiety relievers, called benzodi- azepines, for example, are commonly used as sedatives for many surgical procedures. Anesthesiologists will give less of this drug to surgical patients who have been taking it on a regular basis, he said. This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
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In the Tulane study, 169 surgical patients were given a survey that asked them to circle those medica- tions they were taking in addition to their nonpsychiatric medications. Administered following the preopera- tive examination, the survey included 33 drugs known to affect the central nervous system, including antide- pressants, antipsychotics, benzodiazepines, lithium and over-the-counter drugs known to affect mood, such as insomnia remedies containing melatonin. Patients were not asked to reveal why they were taking the medica- Forty-three percent of patients admitted to taking one or more of the listed drugs. Of those, 35 percent were on benzodiazepines, 19 percent were on combination therapies, and 11 percent were on antipsychotics, “From this survey, we know the number of patients on psychotropic drugs is high, and we suspect there are other patients who did not admit to taking these medications on the survey,” Dr. Scher said. “It is possible that more people take psychiatric drugs than any other class of medications. There has to be some influence of these drugs on anesthesia, but we don’t know what it is.” The researchers are now studying the relationship between anesthesia and postoperative depression in patients who are and are not taking psychiatric drugs, he said. This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
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AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 BLOOD TRANSFUSION REQUIREMENTS FAR GREATER FOR WOMEN
ORLANDO — Women need four times the amount of blood transfusion during coronary artery bypass graft (CABG) surgery and twice the total amount of blood during hospitalization following CABG surgery as men do, researchers from Maimonides Medical Center in Brooklyn reported at the American Society of Blood transfusions are common in patients undergoing CABG surgery, but an analysis of data on 176 CABG patients showed large differences between women and men in transfusion requirements, even among groups of men and women who weighed roughly the same.
“We’ve always assumed women require more blood because they are smaller and have lower levels of red blood cells than men,” anesthesiologist Ketan Shevde, M.D., said. The volume of red blood cells, referred to as hematocrit, is expressed as a percentage of total blood volume. The normal range is between 43 and 49 percent in men and between 37 and 43 percent in women. As expected, men had significantly higher preoperative hematocrit readings than women, Dr. Shevde said. “But the differences in hematocrit levels between the genders were not nearly as large as the differences between men and women in blood transfusion requirements during and after surgery,” he said.
“This study suggests factors other than weight or hematocrit are at work. The next step is to find out In the meantime, the study serves as a signal to health professionals who care for CABG patients to consider modifying their procedures, Dr. Shevde said. “Today, we cross-match the same amount of blood for men and women,” he said. “Now that we believe gender to be an essential determinant of blood transfusion, we may want to cross-match more blood for women.” This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 TECHNIQUE TO RELIEVE LOW BACK PAIN BRIDGES ACUPUNCTURE AND WESTERN MED-
ORLANDO — A treatment that blends the ancient practice of Chinese acupuncture with the newer Western technique of electrical nerve stimulation is bringing superior relief to people with chronic low back pain (LBP), according to the results of a study conducted by anesthesiologists at the University of Texas The technique, known as percutaneous electrical nerve stimulation (PENS), reduced the need for pain medication by half for LBP patients, the researchers reported at the annual meeting of the American Society of That could be good news for many of the millions of Americans who suffer from LBP, because the most common treatment, oral or injected pain medication, can have negative side effects, principal investiga- tor Paul F. White, M.D., Ph.D., said. Traditional treatment can include narcotic pain relievers but they can cause drowsiness and chemical dependence if used long-term. Other treatments involving the use of non-nar- cotic analgesics can interfere with bowel and bladder function, he said.
“Used as part of a comprehensive treatment plan, PENS offers a highly effective supplement to these traditional pain relievers,” Dr. White said. PENS has been used for several years, but its effectiveness as a pain reliever has never been studied, he said. The technique relies on the same basic approach as transcutaneous electrical nerve stimulation (TENS), a pain management method that delivers low levels of electrical current to the nerves supplying the affected area. One theory holds that electrical stimulation works by interrupting pain signals in the central Unlike TENS, which delivers electrical current through special pads positioned on the skin surface, PENS penetrates the skin via a series of ultra-fine, acupuncture-like needles. Anesthesiologists use Western, not Eastern, principles of neuroanatomy in determining where to place the needles, however, Dr. White noted.
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A study of 60 patients with chronic LBP found PENS to be significantly more effective in decreasing pain than either sham-PENS (a placebo), TENS or exercise alone. Patients received each treatment for 30 minutes three times per week for three weeks. They rated their level of pain, physical activity and quality of sleep on a scale of 0 to 10 after completing each type of treatment. After receiving all four treatments, they Ninety-one percent of patients rated PENS as the most effective pain reliever, Dr. White reported.
Patients also scored PENS significantly higher than the other treatments for its ability to improve physical activity, quality of sleep and their sense of “well-being.” In addition, 80 percent of patients said they would be willing to pay “out of pocket” to receive PENS therapy. “PENS is more effective than conventional TENS or exercise in improving short-term outcome in patients with LBP,” Dr. White said. “Now we need to look at its long-term effectiveness.” This news release is protected by copyright. American Society of Anesthesiologists attribution is required.
Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 MEDIA AWARD WINNERS REPRESENT MAGAZINE AND TELEVISION
ORLANDO — Television reporter Lyn Brown and medical journalist Denise Grady will share the spotlight when the American Society of Anesthesiologists (ASA) presents its annual Media Awards.
The presentation ceremony will take place during the ASA annual meeting being held October 17-21 Ms. Brown, the medical correspondent with New York City television station WNYW, receives her award for a newscast segment about office-based anesthesia safety. She interviewed anesthesiologist Rebecca S. Twersky, M.D., for her report. Ms. Brown has worked as a radio and television news broadcaster in several markets across the country, including CNN and CBS News.
Ms. Grady will receive the ASA Media Award for an article she wrote that appeared in the Fall 1997 Time magazine special issue “Heroes of Medicine.” The article, titled “A Child’s Pain,” highlighted the work of anesthesiologist and pediatric pain specialist Charles B. Berde, M.D., of Children’s Hospital, Boston, Mass.
Ms. Grady is currently a staff writer with The New York Times. She also has been a writer with Discover magazine and an assistant editor at The New England Journal of Medicine.
ASA recognizes that if people are informed about the many aspects of anesthesiology and pain man- agement, they will be better able to ask specific questions and make informed decisions about their care should they require surgery. The ASA Media Award is presented each year for a media presentation — broad- cast (television or radio) and/or print (newspaper or magazine) — that informs and educates the public about the medical practice of anesthesiology.
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Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
The recipients of the 1997 ASA Media Award were syndicated television medical reporter James “Red” Duke, M.D., of Houston, Texas, and Boston Globe newspaper reporter Peter J. Howe. Dr. Duke was recognized for his three-part series of reports on the role of anesthesiologists as perioperative physicians. Mr.
Howe was recognized for his feature article about the 150th anniversary of the first public demonstration of ether anesthesia and the evolution of anesthesiology.
Other past recipients of the ASA Media Award have included: Mark Anstendig, producer for NBC News in Los Angeles; John Stupak, host and producer of the weekly syndicated radio program “Sunday Rounds”; Howard Torman, M.D., medical reporter for “CBS This Morning” in New York; and Sheila Mahoney of WKBW-TV “Family Healthcast,” Buffalo, N.Y.
MEDIA ADVISORY:
The deadline for entries for the 1999 ASA Media Award is July 1, 1999. Media presentations related to anes-
thesiology or pain management must be released between July 1, 1998, and June 30, 1999, to be considered
for the 1999 award. Eligible media formats include newspaper articles, consumer-interest magazine articles
and television or radio broadcasts.
Members of the media, their editors or publishers may submit nominations. Requests for nominating formsshould be forwarded to the ASA Communications Department at <communications@ASAhq.org> or call(847) 825-5586.
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Copyright 1998 American Society of Anesthesiologists. All Rights Reserved.
AMERICAN SOCIETY
OF ANESTHESIOLOGISTS
520 N. Northwest Highway • Park Ridge, IL 60068-2573Telephone: (847) 825-5586 • Fax: (847) 825-5658 POLICY CONCERNING PRESS CREDENTIALS
AMERICAN SOCIETY OF ANESTHESIOLOGISTS
1998 ANNUAL MEETING
October 17-21, 1998 • ORLANDO, FLORIDA
REGISTRATION
Registration is complimentary but necessary for the media to attend any ASA Annual Meeting ses-sion(s). Press credentials to cover the ASA Annual Meeting will be granted to no more than three indi-viduals from any one media organization or publication group. Those desiring to send additional rep-resentatives or broadcast media requiring additional staff must contact the ASA Director ofCommunications: before the meeting: call (847) 825-5586; or during the meeting: call (407) 248-5010 or visit the ASA Press Room in the Orlando/Orange County Convention Center, Room 231 A-B.
Media can also register prior to the meeting through the ASA Web site at CREDENTIALS
Only representatives of the following media will be registered: 1. General circulation newspapers or magazines2. Medical or health care publications3. Broadcast media Attendees from publications must represent the editorial staff. Public relations, advertising,
marketing or sales representatives will not be registered. No exceptions will be made.
ASA considers publishers to be part of the editorial staff.
Freelance writers must produce a letter of assignment or evidence of previous or current assign- ments from a medium such as those listed above before a media badge will be issued.
Any individual with a media badge who markets, sells or represents a company for the purpose of sell-ing or promoting a product/service to or obtaining advertising/subscriptions from any registrant orexhibitor, or who violates any other stipulation for credentialing, will immediately forfeit press creden-tials for this and subsequent meetings.
GENERAL CONDITIONS
By showing only their ASA media badge, media representatives may gain admittance to the scientificevents occurring during the Annual Meeting. Special passes for refresher courses are available fromthe press room staff on a first-come, first-served basis. Media representatives should feel free to con-tact the press room staff for assistance in scheduling interviews and locating individuals for interviews.
Tape recording of lectures will not be permitted. Photographs may not be taken during any scientificpresentation but can be arranged before or after a session with the moderator’s permission.
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Source: http://anestit.unipa.it/mirror/asa2/Media/MediaKit/MediaKit.pdf